HomeMy WebLinkAbout623 W 3rd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . INSPECTION REPORT. . . . . . . .
REQUEST:
Date ') -- J-G, -- 0 t-
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
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Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
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INSPECTION NOTES:
By
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Inspected: Date
Remarks:
Time
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RESTORATION REQUIRED . . . . .. YES
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NO V"
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SURFACE RESTORATION.
SURFACE TYPE: D Unimproved D Gravel
[] Repaired by City
D Repaired by Permittee
D No Damage Found
D Asphalt D PCC
Work J'der #
~OMPLETE
D INCOMPLETE
D Other
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)